Division of Diagnostic Imaging, Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht, The Netherlands.
Evidensia Dierenziekenhuis Barendrecht, Barendrecht, The Netherlands.
Vet Radiol Ultrasound. 2024 Sep;65(5):567-577. doi: 10.1111/vru.13398. Epub 2024 Jun 21.
Lumbosacral intervertebral disc herniation (IVDH) is a common cause of lower back pain in dogs and humans. In humans, the vertebral endplate to annulus fibrosus (AF) attachment was implicated as an alternative failure site besides rupture through the dorsal AF (AFF). Endplate junction failure (EPJF) is characterized by IVDH, accompanied by endplate irregularities (type A), rim avulsions (type B), or larger bony avulsions on one (type C) or both endplates (type D), associated with an adjacent endplate defect. This retrospective study reports the CT prevalence of presumed EPJF in dogs and its associations with signalment and other lumbosacral CT abnormalities. CT scans, including the lumbosacral spine of dogs obtained at two institutions, were assessed, yielding 324 scans. Presumed EPJF was found in 69 dogs (21%) and AFF in 68 dogs (21%), commonly at the caudal endplate of the last lumbar vertebra (71%). The remaining 187 dogs did not show presumed EPJF or AFF. Presumed EPJF type A occurred in 49/69, type B in 19/69, and type C in 1/69 dogs. Univariable logistic regression showed that presumed EPJF was associated with significantly higher IVDH grades than AFF. In the multiple regression model, presumed EPJF and AFF remained associated with increasing age and spondylosis deformans. Presumed EPJF was associated with vertebral endplate sclerosis and AFF with zygapophyseal joint osteoarthritis. In conclusion, presumed EPJF was observed on CT in 21% of dogs with lumbosacral IVDH. Prospective studies correlating EPJF on CT with clinical, surgical, and histopathological findings are needed for a better understanding of the underlying pathology and clinical relevance.
腰椎间盘突出症（IVDH）是犬和人类腰痛的常见原因。在人类中，椎体终板与纤维环（AF）的附着被认为是除了通过背侧 AF（AFF）破裂之外的另一个失效部位。终板连接失败（EPJF）的特征是 IVDH，伴有终板不规则（A型）、边缘撕裂（B 型）或一个（C 型）或两个终板（D 型）上较大的骨撕裂，伴有相邻终板缺陷。本回顾性研究报告了犬推定 EPJF 的 CT 患病率及其与品种和其他腰骶部 CT 异常的关联。在两个机构对包括犬腰骶部的 CT 扫描进行了评估，共获得 324 个扫描。在 69 只狗（21%）中发现了推定的 EPJF 和 68 只狗（21%）中的 AFF，常见于最后一个腰椎的尾侧终板（71%）。其余 187 只狗未显示推定的 EPJF 或 AFF。推定的 EPJF 类型 A 发生在 49/69 只狗中，类型 B 发生在 19/69 只狗中，类型 C 发生在 1/69 只狗中。单变量逻辑回归显示，推定的 EPJF 与 AFF 相比，与更高的 IVDH 分级显著相关。在多元回归模型中，推定的 EPJF 和 AFF 与年龄增加和变形性脊柱炎仍然相关。推定的 EPJF 与椎体终板硬化有关，而 AFF 与关节突关节骨关节炎有关。总之，在腰骶部 IVDH 的犬中，CT 上观察到 21%的犬存在推定的 EPJF。需要进行前瞻性研究，将 CT 上的 EPJF 与临床、手术和组织病理学发现相关联，以便更好地了解潜在的病理学和临床相关性。
